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When Jane Cavanaugh, RN, CCM, CPHQ, nurse case manager for Blue Cross and Blue Shield of Minnesota, began managing the care of a Vietnamese woman with lung cancer, she researched beliefs of the Vietnamese culture and tailored her care management plan around them.
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When members are enrolled in Minnesota Senior Health Options from UCare Minnesota, their case manager visits them in their home to meet them and complete an extensive assessment to determine their needs and a plan of care.
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In the first two years of Blue Cross and Blue Shield of North Carolina's fibromyalgia management program, the inpatient admission rate among members enrolled in the program decreased by 23.3%, emergency department visits dropped by 23.1%, and physician visits went down 16.6%.
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With the Centers for Medicare & Medicaid Services (CMS) emphasizing the reduction of hospital readmissions as one way to cut the overall cost of health care for Medicare patients, home health agency managers have evaluated different ways to improve this outcome for their agencies.
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Navigating the health care system often is bewildering for people who were born in the United States and speak English; it may be incomprehensible for some of this country's growing immigrant population, who bring their own cultural beliefs and practices with them.
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A range of factors affects a patient's ability to manage oral medications: cognitive ability, number of medications, and understanding why and how to take medications. To help patients better manage their medications, it is important to identify the reasons they don't and address those in the simplest manner possible.
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Budget-conscious quality managers might want to take a good, hard look at the findings in the latest report from the Dartmouth Atlas Project, in Hanover, NH. It indicates that providing chronically ill Medicare beneficiaries more care at a higher cost does not translate into higher quality care.
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When members of Passport Health Plan are hospitalized in the intensive care unit for asthma, the plan's asthma disease managers visit them on-site and work with the hospital's asthma educator to help them learn to manage their disease.
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Optima Health's asthma disease management program has generated $2.10 in savings for every dollar spent on members who have been continuously enrolled over a five-year period.
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The saying, "It takes a village" applies to asthma control as well, says Pamela Persichilli, RNC, director of clinical operations for Horizon NJ Health.
